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In this paper, we study the (classical) Frobenius problem, namely the problem of finding the largest integer that cannot be represented as a nonnegative integer combination of given, relatively prime, (strictly) positive integers (known as the Frobenius number). The main contribution of this paper are observations regarding a previously known upper bound on the Frobenius number where, in particular, we observe that a previously presented argument features a subtle error, which alters the value of the upper bound. Despite this, we demonstrate that the subtle error does not impact upon on the validity of the upper bound, although it does impact on the upper bounds tightness. Notably, we formally state the corrected result and additionally compare the relative tightness of the corrected upper bound with the original. In particular, we show that the updated bound is tighter in all but only a relatively "small" number of cases using both formal techniques and via Monte Carlo simulation techniques. [ABSTRACT FROM AUTHOR] more...

Background: A recent randomised controlled trial has demonstrated the impact on practice of an educational programme for clinicians. Mentored clinical practice in musculoskeletal physiotherapy resulted in clinically significant improvements in both physiotherapist performance and patient outcomes. The objectives of this study were to explore mentor and mentee perceptions of a mentored clinical practice programme, in order to identify key factors in the process to improve patient outcomes. Methods: Employing a case study design of a mentoring programme that led to improved patient outcomes, mentored clinical practice was explored from multiple perspectives using a grounded theory strategy of enquiry to derive a theory of mentored clinical practice grounded in the views of the participants. Semi-structured interviews with a purposive sample of mentors and mentees were employed along with qualitative observations of mentored clinical practice. Data analysis and collection were concurrent, with analysis an iterative process deriving inductive analytical categories from the data through constant comparison. Findings: Highly informative themes of how the complex interaction between mentor, mentee, patient and environment worked successfully were identified from the data. The mentors' knowledge, additional perspectives, critical analysis and facilitatory style were enabling factors, as were mentees' motivation, openness to criticism and commitment to reflect on practice. Themes around potential threats to the mentees' development were also identified. Overloading or contradictory feedback and lack of relationship with mentees were barriers that mentors could bring; fear, defensiveness, routine working, people-pleasing and lack of experience were potential mentee barriers. A model emerges from the data demonstrating how these themes interact, providing guidance to mentors and mentees to optimise the effectiveness of mentored clinical practice. Conclusion: This study provides a sound basis for future mentored clinical practice, producing a model from key themes from a case study where impact on clinician performance and patient outcomes are established. [ABSTRACT FROM AUTHOR] more...

Introduction: Preserving renal function after robot-assisted partial nephrectomy (RAPN) is important and influenced by the technique of renal reconstruction among other parameters, including ischemia time and amount of healthy renal tissue resected. It is believed that reconstruction with a second layer of cortical renorrhaphy is necessary to prevent urinary leaks and postoperative bleeding, but this is associated with the potential loss of healthy renal parenchyma and may result in worse outcomes postoperatively. Purpose: To assess the safety of omitting cortical renorrhaphy during RAPN. Patients and Methods: A retrospective analysis of 146 consecutive patients undergoing a RAPN with single or double layer renorrhaphy at the Wirral University Teaching Hospital from 2014 to 2019. Data obtained included: Patient demographics, tumor RENAL nephrometry, Perioperative parameters; blood loss, duration, and warm ischemia time (WIT), Postop complications, change in estimated glomerular filtration rate (eGFR) (pre and 3 months postop), length of stay, and oncologic outcomes. Results: In total 146 patients were identified. One hundred-six had double renorrhaphy and 40 inner layer only renorrhaphy. No significant differences were seen between these two cohorts in terms of patient demographics, RENAL nephrometry score, tumor size, or location. Perioperative parameters showed a reduced duration of surgery in the single renorrhaphy group with a mean of 125 minutes compared to143 minutes in the double renorrhaphy ( p = 0.006) and a tendency toward a shorter WIT of 12.9 minutes vs 14.0 minutes reaching borderline statistical significance ( p = 0.05) but no difference in blood loss volume ( p = 0.25). Postoperatively there was no statistical difference in the length of hospital stay ( p = 0.85), loss in eGFR at 3 months (0.06), or complication ( p = 0.56). After a median follow-up of 35 months no recurrences or deaths were observed in either group. Conclusions: Omission of cortical renorrhaphy appears feasible and safe with no urine leaks or excess complications observed. [ABSTRACT FROM AUTHOR] more...

Background Despite persistent calls to measure the effectiveness of educational interventions on patient outcomes, few studies have been conducted. Within musculoskeletal physiotherapy, the effects of clinical mentoring on postgraduate physiotherapists have been explored, but its impact on patient outcomes is unknown. The objective of this trial was to assess the effectiveness of a work-based mentoring programme to facilitate physiotherapist clinical reasoning on patient outcomes. Methods In a stepped-wedge cluster RCT in the musculoskeletal physiotherapy outpatient departments of a large NHS organisation, 16 physiotherapists were randomised by cluster to receive the intervention—150 hours of mentored clinical practice—at one of 3 time periods; control was usual training. 441 patients submitted outcome measures: Patient-Specific Functional Scale (PSFS) (primary outcome measure), EQ-5D-5L, patient activation and patient satisfaction (secondary outcome measures). A further secondary outcome measure of physiotherapist performance was collected by an independent assessor observing the physiotherapists practice. Results 80.0% of intervention patients achieved clinically significant PSFS scores compared with 63.8% of control patients. Binary logistic regression analysis modelling for time, cluster and patient characteristics showed strong statistical evidence for this difference (p = 0.023; odds ratio 4.24, 95%CI 1.22, 14.79). Physiotherapist performance scores improved from a mean of 47.8% (SD 3.60) pre-intervention to a mean of 56.0% (SD 4.24) (p<0.001). There was no statistical evidence for differences between groups on other secondary outcomes. Conclusion This is the first study that we aware of that provides patient outcomes measurement of an established educational intervention in physiotherapy, providing evidence that this type of intervention positively impacts patient outcomes and physiotherapist performance. This provides a basis for further research in education across other healthcare disciplines and outcome measures. [ABSTRACT FROM AUTHOR] more...

Traditional therapeutic interventions against abnormal gene expression in disease states at the level of expressed proteins are becoming increasingly difficult due to poor selectivity, off-target effects and associated toxicity. Upstream catalytic targeting of specific RNA sequences offers an alternative platform for drug discovery to achieve more potent and selective treatment through antisense interference with disease-relevant RNAs. We report a novel class of catalytic biomaterials, comprising amphipathic RNA-cleaving peptides placed between two RNA recognition motifs, here demonstrated to target the TΨC loop and 3′- acceptor stem of tRNA Phe . These unique peptidyl-oligonucleotide ‘dual’ conjugates (DCs) were created by phosphoramidate or thiol-maleimide conjugation chemistry of a TΨC-targeting oligonucleotide to the N -terminus of the amphipathic peptide sequence, followed by amide coupling of a 3′-acceptor stem-targeting oligonucleotide to the free C-terminal carboxylic acid functionality of the same peptide. Hybridization of the DCs bearing two spatially-separated recognition motifs with the target tRNA Phe placed the peptide adjacent to a single-stranded RNA region and promoted cleavage within the ‘action radius’ of the catalytic peptide. Up to 100% cleavage of the target tRNA Phe was achieved by the best candidate ( i.e. DC6) within 4 h, when conformational flexibility was introduced into the linker regions between the peptide and oligonucleotide components. This study provides the strong position for future development of highly selective RNA-targeting agents that can potentially be used for disease-selective treatment at the level of messenger, micro, and genomic viral RNA. [ABSTRACT FROM AUTHOR] more...

Background: Despite persistent calls to measure the effectiveness of educational interventions on patient outcomes, few studies have been conducted. Within musculoskeletal physiotherapy, the effects of postgraduate clinical mentoring on physiotherapist performance have been assessed, but the impact of this mentoring on patient outcomes remains unknown. The objective of this trial is to assess the effectiveness of a work-based mentoring programme to facilitate physiotherapist clinical reasoning on patient outcomes in musculoskeletal physiotherapy. Methods/Design: A stepped wedge cluster randomised controlled trial (CRCT) has been designed to recruit a minimum of 12 senior physiotherapists who work in musculoskeletal outpatient departments of a large National Health Service (NHS) organization. Participating physiotherapists will be randomised by cluster to receive the intervention at three time periods. Patients will be blinded to whether their physiotherapist has received the intervention. The primary outcome measure will be the Patient-Specific Functional Scale; secondary outcome measures will include the EQ-5D, patient activation, patient satisfaction and physiotherapist performance. Sample size considerations used published methods describing stepped wedge designs, conventional values of 0.80 for statistical power and 0.05 for statistical significance, and pragmatic groupings of 12 participating physiotherapists in three clusters. Based on an intergroup difference of 1.0 on the PSFS with a standard deviation of 2.0, 10 patients are required to complete outcome measures per physiotherapist, at time period 1 (prior to intervention roll-out) and at each of time periods 2, 3 and 4, giving a sample size of 480 patients. To account for the potential loss to follow-up of 33%, 720 sets of patient outcomes will be collected. All physiotherapist participants will receive 150 hours of mentored clinical practice as the intervention and usual in-service training as control. Consecutive, consenting patients attending treatment by the participating physiotherapists during data collection periods will complete outcome measures at baseline, discharge and 12 months post-baseline. The lead researcher will be blinded to the allocation of the physiotherapist when analyzing outcome data; statistical analysis will involve classical linear models incorporating both an intervention effect and a random intercept term to reflect systematic differences among clusters. [ABSTRACT FROM AUTHOR] more...

Highlights: [•] Low-cost vacuum-evaporation route for roll-to-roll production of organic circuits demonstrated. [•] DNTT transistors with mobility ∼1cm2/Vs produced at high yield: 90% for 90-TFT arrays, 100% for 27-inverter arrays. [•] Ring oscillator frequency ∼2kHz, severely limited by parasitic gate overlap capacitances. [•] Stable RO frequency for 8h continuous operation but amplitude decreases. [•] Environmentally stable – untested ring oscillators operate as new after 1month in storage. [Copyright &y& Elsevier] more...

Reduction of the bit size in conventional magnetic recording media is becoming increasingly difficult due to the superparamagnetic limit. Bit patterned media (BPM) has been proposed as a replacement technology as it will enable hard disk areal densities to increase past 1 Tb in−2. Block copolymer directed self-assembly (BCP DSA) is the leading candidate for forming BPM due to its ability to create uniform patterns over macroscopic areas. Here we review the latest research into two different BCP DSA techniques: graphoepitaxy and chemoepitaxy (or chemical prepatterning). In addition to assessing their potential for forming high density bit patterns, we also review current approaches using these techniques for forming servo patterns, which are required for hard disk drive (HDD) operation. Finally, we review the current state of UV nanoimprint lithography, which is the favoured technique for enabling mass production of BPM HDDs. [ABSTRACT FROM AUTHOR] more...

Background. Despite improvements in safety seen over the last 20 years, percutaneous renal biopsy is still associated with haemorrhagic complications. Due to concerns over delayed bleeding, most nephrologists would advocate overnight observation. Recent evidence in both adult and paediatric populations suggest that in some groups, this is unnecessary. Since 1991, we have provided a day-case renal biopsy service performing 70 such procedures per year. In this study, we present a retrospective analysis of this practice.Methods. A total of 192 patients over a consecutive 3-year period were analysed retrospectively. Patients were selected according to standardized criteria, and biopsy was performed using a modern technique (automated biopsy needles under ultrasound guidance). Complications were identified by examination of case notes and local hospital admission databases, and by telephone interview. Our pathology database was examined for sample adequacy and diagnosis.Results. There were no delayed complications in the study group with 187 patients (97.4%) being discharged home on the same day. Major complications occurred in five patients (2.6%), all related to bleeding. Of these, two needed radiological intervention to achieve haemostasis. Sufficient tissue for diagnosis was achieved in 97% of cases, with a mean of 47 ± 23 glomeruli obtained per patient. Most biopsies were obtained with ≤ 2 passes (84%).Conclusions. Our findings show that in selected adult patients, renal biopsy can be performed as a day-case procedure. Given the benefits of day-case strategies in terms of patient and healthcare costs, we advocate increased utilization of this technique. [ABSTRACT FROM AUTHOR] more...

Recounts the author's experience of working with the International Committee of the Red Cross (ICRC) in southern Afghanistan. Arrival in the town of Kandahar; Background on the Taliban movement; Description of the ICRC compound; Problems faced by the ICRC. more...

Abstract Meningococcal infection usually presents as a severe illness with septicaemia, cardiovascular collapse and a purpuric rash. Less commonly, it presents in a chronic form with an intermittent course over a number of weeks. Chronic meningococcaemia may mimic other conditions, such as viral illness or autoimmune disease. Early diagnosis of chronic meningococcaemia is essential because it may progress into the more familiar acute form. Emergency physicians need to be aware of the disease and its clinical features so that appropriate interventions can be made when a patient presents with a suggestive clinical picture. In this article, we present a case of chronic meningococcaemia that was seen three times in an emergency department before the correct diagnosis was made. We will also review the pathophysiology and the clinical features that may aid in the early diagnosis of this unusual condition. [ABSTRACT FROM AUTHOR] more...

Background: Rural provider-to-provider telehealth is growing globally. It is used to both facilitate equitable access to specialist healthcare services for those living in rural and remote areas and provide support to place-based providers. There is limited research on the implementation of these services, especially in an emergency or inpatient hospital setting. The Western Australia Country Health Service (WACHS) Command Centre is one such example. First implemented in 2012, the Command Centre services a geographical area covering 2.55 million square kilometres, a population of approximately 550,000, and provides five clinical streams including Emergency, Mental Health Emergency, Midwifery and Obstetrics Emergency, Inpatient, and Palliative Care Afterhours Telehealth Services. Objectives: This study aimed to evaluate the implementation and access of rural provider-to-provider telehealth in country Western Australia, for the years 2012 to 2023. Methods: A retrospective observational analysis was conducted of all patient contacts managed by clinical telehealth streams of the Command Centre, between 31 August 2012 and 31 December 2023. Utilising descriptive statistics, analyses was informed by the expanded Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) Framework and Implementation Outcomes Framework (IOF) definitions. Results: Over the near 12-year period, a total of 215,965 service contacts were analysed from the five Command Centre clinical streams. There was large variation in the reach and adoption of services across regions, sites, and health facility types, however service scope and activity has increased steadily over time (maintenance). 95 of the 103 WACHS-managed sites had utilised Command Centre clinical telehealth services. The Command Centre has seen an increase in the proportion of clinical telehealth services provided to the most disadvantaged populations, demonstrating improved equity of access (effectiveness) over time. Conclusion: There is a steady expansion in the availability of provider-to-provider clinical telehealth services delivered by the WACHS Command Centre across country WA, but with wide variability of usage depending on region, site, and health facility type. The results of this study show there is a need to understand the contextual factors influencing the adoption, implementation, and sustainability of the service. [ABSTRACT FROM AUTHOR] more...

Relates the author's experiences as a health delegate in an International Committee of the Red Cross war surgical hospital in Kenya. Emphasis of the hospital; Commonest surgical procedures; Pediatric mortality rate. more...

An abstract of the article "Directed Self-Assembly of Block Copolymers for Use in Bit Patterned Media Fabrication" by Rhys Alun Griffiths and colleagues is presented.

Background: Despite persistent calls to measure the effectiveness of educational interventions on patient outcomes, few studies have been conducted. Within musculoskeletal physiotherapy, the effects of postgraduate clinical mentoring on physiotherapist performance have been assessed, but the impact of this mentoring on patient outcomes remains unknown. The objective of this trial is to assess the effectiveness of a work-based mentoring programme to facilitate physiotherapist clinical reasoning on patient outcomes in musculoskeletal physiotherapy.Methods/design: A stepped wedge cluster randomised controlled trial (CRCT) has been designed to recruit a minimum of 12 senior physiotherapists who work in musculoskeletal outpatient departments of a large National Health Service (NHS) organization. Participating physiotherapists will be randomised by cluster to receive the intervention at three time periods. Patients will be blinded to whether their physiotherapist has received the intervention. The primary outcome measure will be the Patient-Specific Functional Scale; secondary outcome measures will include the EQ-5D, patient activation, patient satisfaction and physiotherapist performance. Sample size considerations used published methods describing stepped wedge designs, conventional values of 0.80 for statistical power and 0.05 for statistical significance, and pragmatic groupings of 12 participating physiotherapists in three clusters. Based on an intergroup difference of 1.0 on the PSFS with a standard deviation of 2.0, 10 patients are required to complete outcome measures per physiotherapist, at time period 1 (prior to intervention roll-out) and at each of time periods 2, 3 and 4, giving a sample size of 480 patients. To account for the potential loss to follow-up of 33%, 720 sets of patient outcomes will be collected.All physiotherapist participants will receive 150 hours of mentored clinical practice as the intervention and usual in-service training as control. Consecutive, consenting patients attending treatment by the participating physiotherapists during data collection periods will complete outcome measures at baseline, discharge and 12 months post-baseline. The lead researcher will be blinded to the allocation of the physiotherapist when analyzing outcome data; statistical analysis will involve classical linear models incorporating both an intervention effect and a random intercept term to reflect systematic differences among clusters.Trial Registration: Assigned 31 July 2012: ISRCTN79599220. [ABSTRACT FROM AUTHOR] more...

Hyaluronan (HA) is a ubiquitous extracellular matrix glycosaminoglycan composed of repeated disaccharide units of alternating D-glucuronic acid and D-N-acetylglucosamine residues linked via alternating β-1,4 and β-1,3 glycosidic bonds. HA is synthesized in humans by HA synthase (HAS) enzymes 1, 2, and 3, which are encoded by the corresponding HAS genes. Previous in vitro studies have shown characteristic changes in HAS expression and increased HA synthesis in response to wounding and proinflammatory cytokines in human peritoneal mesothelial cells. In addition, in vivo models and human peritoneal biopsy samples have provided evidence of changes in HA metabolism in the fibrosis that at present accompanies peritoneal dialysis treatment. This review discusses these published observations and how they might contribute to improvement in peritoneal dialysis. [ABSTRACT FROM AUTHOR] more...

We report the development of a vacuum-evaporation route for the roll-to-roll fabrication of functioning organic circuits. A number of key findings and observations are highlighted which influenced the eventual fabrication protocol adopted. Initially, the role of interface roughness in determining carrier mobility in thin film transistors (TFTs) is investigated. Then it is shown that TFT yield is higher for devices fabricated on a flash-evaporated-plasma-polymerised tri(propyleneglycol) diacrylate (TPGDA) gate dielectric than for TFTs based on a spin-coated polystyrene (PS) dielectric. However, a degradation in mobility is observed which is attributed to the highly polar TPGDA surface. It is shown that high mobility, low gate-leakage currents and excellent stability are restored when the surface of TPGDA was buffered with a thin, spin-coated PS film. The resulting baseline process allowed arrays of functional circuits such as ring oscillators, NOR/NAND logic gates and S–R latches to be fabricated with high yield and their performance to be simulated. [ABSTRACT FROM AUTHOR] more...

Solution phase exfoliation of graphite to yield multilayer graphene is used to form transparent electrodes, when transferred to polymer substrates. The electrochemical performance of these electrodes is determined and their use as optically-transparent electrodes for spectro- electrochemical applications is described [ABSTRACT FROM AUTHOR] more...

We report the fabrication of a range of organic circuits produced by a high-yielding, vacuum-based process compatible with roll-to-roll production. The circuits include inverters, NAND and NOR logic gates, a simple memory element (set–reset latch), and a modified Wilson current mirror circuit. The measured circuit responses are presented together with simulated responses based on a previously reported transistor model of organic transistors produced using our fabrication process. Circuit simulations replicated all the key features of the experimentally observed circuit performance. The logic gates were capable of operating at frequencies in excess of 1 kHz while the current mirror circuit produced currents up to \(18~\mu \) A. [ABSTRACT FROM AUTHOR] more...

This paper presents a model to assess the customer service of an airport and suggests opportunities for service improvement. The model is validated through a case study of Dubai International Airport. Semi-structured interviews were used to elicit relevant information. The assessment model was developed drawing on a thorough review of the literature. The model combines the features of three models, including the boomerang model, inter-cultural model and pleasure model, and satisfies five criteria, namely, customer satisfaction, customer loyalty, cultural diversity, highly mobile population and competition with other airports in the Middle East. The model was developed for assessing customer service at airports in the United Arab Emirates, but could easily be adapted for airports elsewhere. [ABSTRACT FROM AUTHOR] more...

We obtain a transference bound for vertices of corner polyhedra that connects two well-established areas of research: proximity and sparsity of solutions to integer programs. In the knapsack scenario, it implies that for any vertex x* of an integer feasible knapsack polytope P(a,b) = {x ∈ ℝ≥0n : a-T!K = b}, a ∈ &#8484>0n, there exists an integer point z* ∈ P(a,b) such that, denoting by s the size of the support of z* and assuming s > 0, || x* - z* ||∞ 2s-1/s < ||α||∞, where || · ||∞ stands for the l∞-norm. The bound gives an exponential in s improvement on previously known proximity estimates. In addition, for general integer linear programs we obtain a resembling result that connects the minimum absolute nonzero entry of an optimal solution with the size of its support. [ABSTRACT FROM AUTHOR] more...

Objective: To determine the nature, incidence and risk factors for sedation-related events during ED procedural sedation, with particular focus on the drugs administered. Methods: Eleven Australian EDs enrolled consecutive adult and paediatric patients between January 2006 and December 2008. Patients were included if a sedative drug was administered for an ED procedure. Data collection was prospective and employed a specifically designed form. Multivariate logistic regression was employed to determine risk factors for sedation-related events. Results: Two thousand, six hundred and twenty-three patients were enrolled (60.3% male, mean age 39.2 years). Reductions of fracture/dislocations of shoulders, wrists and ankles were most common. Four hundred and sixty-one (17.6%) cases experienced at least one airway event that required intervention. Airway obstruction, hypoventilation and desaturation occurred in 12.7%, 6.4% and 3.7% of all patients, respectively. Two thousand, one hundred and forty-six cases had complete datasets for further analyses. Increasing age and level of sedation, pre-medication with fentanyl, and sedation with propofol, midazolam or fentanyl were risk factors for an airway event ( P < 0.05). Ketamine was a protective factor. Hypotension (systolic pressure <80 mmHg) occurred in 34 (1.6%) cases with midazolam being a significant risk factor ( P < 0.001). Vomiting also occurred in 34 (1.6%) cases, 12 of whom required an intervention. One patient aspirated. Vomiting occurred after administration of all drugs but was not associated with fasting status. Other events were rare. Conclusions: Sedation-related events, especially airway events, are common but very rarely have an adverse outcome. Elderly patients, deeply sedated with short-acting agents, are at particular risk. The results will help tailor sedation to individual patients. [ABSTRACT FROM AUTHOR] more...

Objective: The aim of the present study was to describe procedural sedation practices undertaken in a spectrum of Australian EDs. Methods: Eleven Australian EDs enrolled consecutive adult and paediatric patients between January 2006 and December 2008. Patients were included if a sedative drug was administered for an ED procedure. Data collection was prospective and used a specifically designed data collection document. Results: 2623 patients were enrolled. 1581 were male (60.3%, 95% CI 58.4-62.2) and the mean patient age was 39.2 (SD 25.2) years. Reductions of fracture/dislocated shoulders (694 cases, 26.7%), wrist/forearm fractures (403, 15.5%) and tibia/fibula fractures (341, 13.1%) were the most common procedures. Procedures were supervised by consultants and registrars in 1424 (54.3%) and 1025 (39.1%) cases, respectively. Of 2413 patients with complete fasting status data, 1252 (51.9%, 95% CI 49.9-53.9) patients had consumed food or fluid in the previous 6 h. 1399 (53.3%, 95% CI 51.4-55.3) patients received pre-procedural medication. Pre-procedural morphine (894, 34.1%) exceeded fentanyl use (323, 12.3%), both as a sole agent and in combination with another agent. The principal sedatives used alone were propofol (857, 38.5%), midazolam (224, 10%) and ketamine (165, 7.4%). Ketamine and nitrous oxide were most commonly used in children with propofol, midazolam and opiates largely restricted to adults ( P < 0.001). The intra-procedural use of adjunct fentanyl exceeded that of morphine (ratio 4:1). Conclusions: Procedural sedation practice across Australian EDs is varies considerably. Procedural sedation 'best practice' guidelines, based upon the findings of the present study and the available evidence, are recommended. [ABSTRACT FROM AUTHOR] more...

Objective: To determine factors associated with failure to successfully complete a procedure during sedation in the ED. Methods: Eleven Australian EDs enrolled consecutive adult and paediatric patients between January 2006 and December 2008. Patients were included if a sedative drug was administered for an ED procedure and the success or failure of the procedure was recorded. Results: Data were available for 2567 patients. Of these, 1548 (60.3%, 95% CI 58.4-62.2) were male and 456 (17.8%, 95% CI 16.3-19.3) were age <16 years. The most common procedures performed were reduction of major joints and laceration repair. A total of 149 procedures (5.8%, 95% CI 5.0-6.8) failed. There were significant differences in failure rates between the types of procedure undertaken, with reduction of hips, digits and mandibles associated with the highest failure rates ( P < 0.001). In adults, body weight >100 kg was also associated with increased risk of procedural failure (odds ratio 2.3, 95% CI 1.3-4.1). Ketamine used as a single agent had the lowest procedural failure rate (2.5%, 95% CI 1.1-5.4) whereas propofol had the highest (5.9%, 95% CI 4.6-7.6). However, these two drugs were generally used in different age groups and for different procedures. Conclusions: Procedures performed under sedation in the ED have a low failure rate. However, increased body weight and specific procedures, such as hip reduction, are associated with significantly higher failure rates. Special consideration should be given to these patient groups before undertaking sedation in the ED. [ABSTRACT FROM AUTHOR] more...